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Folly Beach Library
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Edgar Allan Poe/Sullivan's Island Library
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Wando Mount Pleasant Library
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Village Library
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McClellanville Library
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Keith Summey North Charleston Library
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Hurd/St. Andrews Library
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The epidemiology of dying within 48 hours of presentation to emergency departments: a retrospective cohort study of older people across Australia and New Zealand.
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- Author(s): Sweeny, Amy L; Alsaba, Nemat; Grealish, Laurie; Denny, Kerina; Lukin, Bill; Broadbent, Andrew; Huang, Ya-Ling; Ranse, Jamie; Ranse, Kristen; May, Katya; Crilly, Julia
- Source:
Age & Ageing; Apr2024, Vol. 53 Issue 4, p1-12, 12p- Subject Terms:
CARDIOVASCULAR disease diagnosis; RISK assessment; DEATH; RESEARCH funding; PATIENTS; PALLIATIVE treatment; LOGISTIC regression analysis; HOSPITAL admission & discharge; HOSPITAL emergency services; RETROSPECTIVE studies; HOSPITALS; DESCRIPTIVE statistics; HOSPITAL mortality; AGE distribution; LONGITUDINAL method; AMBULANCES; STATISTICS; TERMINAL care; MEDICAL needs assessment; CONFIDENCE intervals; MEDICAL triage; INDIGENOUS Australians; EVALUATION - Source:
- Additional Information
- Subject Terms:
- Abstract: Background Emergency department (ED) clinicians are more frequently providing care, including end-of-life care, to older people. Objectives To estimate the need for ED end-of-life care for people aged ≥65 years, describe characteristics of those dying within 48 hours of ED presentation and compare those dying in ED with those dying elsewhere. Methods We conducted a retrospective cohort study analysing data from 177 hospitals in Australia and New Zealand. Data on older people presenting to ED from January to December 2018, and those who died within 48 hours of ED presentation, were analysed using simple descriptive statistics and univariate logistic regression. Results From participating hospitals in Australia or New Zealand, 10,921 deaths in older people occurred. The 48-hour mortality rate was 6.43 per 1,000 ED presentations (95% confidence interval: 6.31–6.56). Just over a quarter (n = 3,067, 28.1%) died in ED. About one-quarter of the cohort (n = 2,887, 26.4%) was triaged into less urgent triage categories. Factors with an increased risk of dying in ED included age 65–74 years, ambulance arrival, most urgent triage categories, principal diagnosis of circulatory system disorder, and not identifying as an Aboriginal or Torres Strait Islander person. Of the 7,677 older people admitted, half (n = 3,836, 50.0%) had an encounter for palliative care prior to, or during, this presentation. Conclusions Our findings provide insight into the challenges of recognising the dying older patient and differentiating those appropriate for end-of-life care. We support recommendations for national advanced care planning registers and suggest a review of triage systems with an older person-focused lens. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Age & Ageing is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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